Pathophysiology

After completing this chapter, the learner should be able to: • Define basic terminology used in the discussion of pathophysiology. • Discuss cultural, ethnic, geographical, and age-related differences regarding health and illness. • Discuss the ICF Disablement Model: define terms associated with it and discuss its relevance to physical therapy. Chapter Contents • • • • • • • • • Physical therapist assistants (PTAs) are expected to possess a basic understanding of diseases and conditions, whether they are the focus of physical therapy intervention or comorbidities that could affect interventions and recovery. This text is intended to introduce PTA students to Pathophysiology and provide them with knowledge necessary for addressing patients and health professionals in clinical settings. Students enrolled in a course in Pathophysiology should bring to the course a solid foundation of Anatomy and Physiology, as this text is intended to build upon knowledge of normal body structures and functions. An understanding of how the body works when a person is well is essential to understanding how health and homeostasis can be disrupted by disease or injury. A common language is a logical place to begin the discussion of pathophysiology. Listed below are several terms and definitions that will be used throughout the text and in most discussions of disease and the study of disease. Condition – state of being. In medical terms, anything that disrupts the body’s normal homeostasis can b...

Critical thinking and clinical reasoning lead to correct clinical judgments and practice, and they are fundamental requisites in nursing. From all nursing subjects, pathophysiology is undoubtedly the most important. This discipline lays the foundation of thinking like a nurse, and it must be deeply understood for the other disciplines, including biochemistry, pharmacology, and even nursing, to make sense. But what is pathophysiology, and how does it exactly relate to nursing? What Is Pathophysiology? According to its scientific definition, the pathophysiology is the study of the abnormal physiological processes which may cause or are associated with disease or injury. The discipline is so important that it is one of the first courses you’ll attend during nursing school. In broad lines, pathophysiology covers: • Diseases and etiology: Pathophysiology studies not only the diseases, but also their etiology – or causes, including congenital, genetic, and acquired diseases. • Signs and symptoms: This discipline also studies both the objective and subjective evidence of disease. Signs are usually objective evidence, such as blood in the stool, whereas symptoms are vaguer in nature, such as a headache. Nevertheless, they both require further examination. • Investigation and diagnosis: During a pathophysiology course, nursing students will also learn how to investigate the signs and symptoms to determine a diagnosis. Investigations can include anything from ocular observations to ...

Pathophysiology Hashimoto’s disease is a form of autoimmune disease that destroys thyroid cells by cell and antibody-mediated immune processes (Hashimoto Disease, 2019). It is a typical type of hypothyroidism in iodine-sufficient areas, and can also cause inflammation of thyroid with enlarged goiter. Between 0.1% to 0.2% of the U.S. population is affected by this disease (McCance & Huether, 2014, Chapter 22), and it is more common among women and the elderly (Hashimoto Disease, 2019). The leading cause of hypothyroidism is due to the disruption of the thyroid gland (Hashimoto Disease, 2019). It can relate to a familial cause of any thyroid diseases or environmental factors that trigger the diseases (Orlowski, 2007). Sodium iodide symporter (an intrinsic plasma membrane glycoprotein that mediates the active transport of iodide in the thyroid gland) can take up toxins to the thyroid follicles where free radicals are generated. Free radicals then activate immune responses and sensitize immune cells to thyroid proteins. Thyroid epithelial cells (thyrocytes) are progressively depleted and gradually replaced by mononuclear cell infiltration and fibrosis. Sensitization of autoreactive CD4+ T-helper cells to thyroid antigens initiates the death of thyrocytes by multiple immunologic mechanisms: 1. CD8+ cytotoxic T cell-mediated cell death; 2. cytokine-mediated cell death; and 3. binding of antithyroid antibodies. The antibodies can bind to thyroid peroxidase enzyme, thyroglobulin, ...

Alzheimer’s disease (AD) is characterized by two pathological lesions, beta-amyloid (Aβ) plaques and neurofibrillary tangles, that are progressively distributed throughout the brain. These lesions are associated with disruption of the communication pathways between neurons, neuron degeneration, brain atrophy, and functional loss. However, the specific etiology of AD remains uncertain (Sperling et al, 2011). With synaptic activation: (1) intraneuronal levels of Aβ (red) are reduced, (2) Aβ secretion is augmented, (3) neprilysin-induced Aβ degradation is enhanced, (4) transcription of pro-survival genes (AID) increases, (5) local ATP synthesis rises at synapses, and (6) tau secretion is augmented (Tampellini, 2015). Beta-amyloid plaques The outer cell membrane of neurons contains an amyloid precursor protein (APP). In the normal brain, alpha-secretase and gamma-secretase cut APP into smaller protein fragments that are thought to be helpful to neurons and then later cleared from the brain. In AD, beta-secretase and gamma-secretase cut APP into small Aβ fragments. Researchers hypothesize that the Aβ oligomers disrupt neuronal cell signaling and communication at the synapses and later stick together to form beta-amyloid plaques (NIA, 2015). Researchers believe the beta-amyloid plaques may also trigger an inflammatory immune reaction that results in neuronal death. In early onset familiar AD, the formation of Aβ plaques is related to autosomal dominant mutations of the APP gene,...

Recent Examples on the Web This extraordinary improvement in longevity is a testament to our advancements in the treatment and management of HIV, from discoveries and developments in anti-retroviral drugs, treatments for opportunistic infections, and insights into the pathophysiology of this fascinating virus. — Rebecca Kreston, Discover Magazine, 25 Nov. 2015 Long-term, mandated innovation education needs to be integrated into medical schools and residencies the same way pathophysiology, medical ethics, and other core knowledge is required today. — Marc Succi, STAT, 24 May 2022 The company’s drug, elamipretide, had shown an ability to normalize the synthesis of cardiolipin, a substance mitochondria need to operate correctly and generate energy for the body, thus directly addressing the underlying pathophysiology in this disease. — Emily Milligan, STAT, 16 Sep. 2021 In conclusion, our data suggest the hypothalamus to be the primary generator of migraine attacks which, due to specific interactions with specific areas in the higher and lower brainstem, could alter the activity levels of the key regions of migraine pathophysiology. — Neuroskeptic, Discover Magazine, 22 May 2016 The quantitative alteration of these cytokines (and others in the same cascade) could help explain in part the complex pathophysiology of Behçet's disease and suggest new therapeutic avenues. — Razib Khan, Discover Magazine, 26 July 2010 As long as enough mystery enshrouds the exact pathophysiology of ...

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